TERRITORY IS WESTCHESTER Bilingual candidates (Spanish & China) strongly preferred Responsible for the completion of UAS (Uniform Assessment System) Initial Assessments and Reassessments based on New York state requirements, guidelines and training provided by the company and/or outside resources; enrollment paperwork materials required to appropriately process member`s application for enrollment; and UAS Tasking Tool based on guidelines and training provided by the company and/or outside resources. Responsible for correction and revision of UAS, paperwork, and tasking tool documentation based on review and feedback provided through quality and associated review processes. - Completes approved New York State UAS Initial Assessment Tool and/or Clinical Reassessment used to define eligibility for community based long term care services; develops plan of care for members. - Completes enrollment paperwork, progress notes and tasking tool in member`s home to assist in determining eligiblity for services; reviews all data collected for accuracy and completion prior to submission. - Charts all contacts and findings within appropriate tool and form per policy and procedure and within deadlines. - Attends training and continuing education sessions focused on the proper completion of UAS documentation, enrollment paperwork, and tasking tool. - Focuses on continuous improvement and quality excellence in the completion of all material associated with the initial enrollment/continued enrollment of members in the plan. - Supports initiatives of the Quality Assessment and Performance Improvement Committee. General Job Information Title Assessment Nurse - UAS Grade 24 Job Family Clinical Services Group Country United States of America FLSA Status United States of America (Exempt) Recruiting Start Date 6/25/2019 Date Requisition Created 6/25/2019 Work Experience Managed Healthcare, UAS (Uniform Assessment System) Education Associates: Nursing (Required), Bachelors: Nursing License and Certifications - Required RN - Registered Nurse, State and/or Compact State Licensure - Care Mgmt License and Certifications - Preferred CCM - Certified Case Manager - Care Mgmt, CCP - Chronic Care Professional - Care Mgmt Other Job Requirements Responsibilities - Minimum 2 years clinical experience with focus in managed care, including disease or case management. - Trained and knowledgeable in the NY UAS. Ability to understand and apply principals of Care Management and Person Centered Service Planning. - Solid assessment skills. - Ability to understand and apply coverage guidelines and benefit limitations. - Familiar with clinical needs and disease processes for chronic physical and behavioral illnesses (depression, challenging behaviors, Alzheimer`s disease and other disease-related dementias). - Understands and adapts appropriately to issues related to communication, cognitive or other barriers. - Strong organizational skills and the ability to prioritize and follow through on multiple projects in a timely manner. - Must be comfortable with conducting home visits and commuting within the service area. - Must be able to travel multiple boroughs via car or commuting via public transportation. - Basic computer skills and demonstrates a willingness to learn more advanced skills. - Home Care, Long-Term Care, MLTC experience preferred, including appropriate support services in the community and accessing and using durable medical equipment (DME). - Experience in utilization review, concurrent review and/or risk management a plus. - Bi or multilingual. Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position. Associated topics: care unit, ccu, infusion, intensive, intensive care, neonatal, nurse clinical, nurse rn, recovery, surgery
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